Table of Contents
ISRN Hypertension
Volume 2013, Article ID 780702, 9 pages
http://dx.doi.org/10.5402/2013/780702
Review Article

Meta-Analysis of the Hemodynamic Properties of Antihypertensive Medications

1Department of Medicine, School of Medicine, University of South Carolina, One Richland Medical Park, Suite 300, Columbia, SC 29203, USA
2Department of Family Medicine, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA
3University Hospitals Medical Practice, Berea Health Center, 201 Front Street, Berea, OH 44017, USA
4Pakistan Atomic Energy Hospital, Islamabad, Pakistan
5Center for Global Health and Diseases, Case Western Reserve University, Cleveland, OH 44106, USA

Received 16 August 2012; Accepted 6 September 2012

Academic Editors: C. Saha and B. Waeber

Copyright © 2013 Imran Hasan Iftikhar et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. While all antihypertensive medications lower blood pressure, hemodynamic properties of various classes of antihypertensive medications may differ. Objective. To perform a meta-analysis to compare the hemodynamic properties of different classes of antihypertensive medications. Methods. Studies involving the treatment of hypertension using the effect of ACEIs, β-blockers, CCBs and thiazide diuretics on plasma volume (PV), cardiac output (CO) or stroke volume (SV) were searched using online databases prior to May 2011. Studies had to be written in the English language, studying human subjects with a single pharmacological agent (monotherapy), and with a minimum duration of 4 weeks. Results. Seventy-five (75) studies that enrolled a total of 1522 subjects were included. All four antihypertensive classes lowered blood pressure. β-blockers decreased heart rate; the other classes had no effect upon heart rate. ACEIs increased PV; the other classes had no effect upon PV. β-blockers and thiazide diuretics decreased CO while ACEIs and CCBs had no effect upon CO. β-blockers and CCBs increased SV, thiazide diuretics decreased SV, and ACEIs did not change SV. Conclusion. In the treatment of uncomplicated hypertension, the various classes of antihypertensive medications differ from each other in terms of their non-blood pressure lowering hemodynamic properties.